TOPLINE:

Placental growth factor (PGF) levels below 100 pg/mL demonstrate 100% sensitivity and specificity for early-onset preeclampsia at 20-24 weeks gestation in pregnancies complicated by sickle cell disease (SCD), marking the first demonstration of this biomarker's utility in this high-risk population.

METHODOLOGY:

• Researchers conducted a retrospective study at Mount Sinai Hospital in Toronto, Canada, from January 2017 to September 2021, including pregnant individuals with SCD who had at least one PGF measurement between 20+0 and 35+6 weeks gestation.
• Analysis included pregnant Black control individuals without SCD who had suspected preeclampsia or growth restriction during the same period.
• Investigators extracted maternal and neonatal outcomes from medical records for comprehensive evaluation.

TAKEAWAY:

• At 20-24 weeks gestation, a PGF level of 87 pg/mL achieved 100% sensitivity and specificity for early-onset preeclampsia prediction, with a receiver operating characteristic area under the curve of 1.000 (P < .001).
• Using a < 100-pg/mL cut-off at 20-24 weeks maintained 100% sensitivity, specificity, positive predictive value, and negative predictive value for early-onset preeclampsia.
• For late-onset preeclampsia prediction at 20-24 weeks, a PGF level of 832 pg/mL was required for 100% sensitivity, though with reduced specificity.
• The < 100-pg/mL cut-off showed only 20% sensitivity with 100% specificity for late-onset preeclampsia, with a positive predictive value of 100% and negative predictive value of 93.1%.

IN PRACTICE:

“This study demonstrates for the first time the critical role of PIGF [placental growth factor] in predicting early onset preeclampsia in pregnancies of individuals with SCD. Specifically, a PIGF cut-off < 100 pg/mL proved highly discriminative in predicting early-onset preeclampsia, with 100% sensitivity and specificity at 20-24 weeks gestation,” the authors of the study wrote.

SOURCE:

The study was led by Evangelia Vlachodimitropoulou, Mount Sinai Hospital in Toronto, Ontario, Canada. It was published online in Blood Advances.

LIMITATIONS:

According to the authors, future studies should focus on validating these findings in larger, multicentre cohorts of pregnant individuals with SCD and exploring the integration of PGF with other biomarkers. The researchers noted that investigation of the interplay between SCD-specific factors and placental dysfunction may provide further insights. Additionally, the data did not allow for exploration of the impact of transfusions, hydroxyurea, or anticoagulation.

DISCLOSURES:

The study was funded by the Mount Sinai Hospital Department of Obstetrics and Gynaecology “Lee Adamson Award” in Toronto, Ontario, Canada. Kevin H. M. Kuo declared receiving research funding from Agios Pharmaceuticals and Pfizer and consultancy fees from multiple pharmaceutical companies and serving on the data safety monitoring board for Sangamo. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.